COVID-19: 4/22/2020 Update (Including Today’s Health Department Briefing)

Saint John's Lutheran Church, Knoxville, April 2020
Saint John’s Lutheran Church, Knoxville, April 2020

I appreciate everyone stopping in in the middle of your day and taking a break from those great Facebook conversations designed to build a better community and country and all of that illuminated and illuminating discussion of science. Feel free to bring that conversation here, minus the conspiracy theories, self-righteous pronouncements, name calling and general know-it-allness. It’s dangerous out there and I don’t just mean from air-borne pathogens. Avoid the poison, friends.

International News:

There are currently 2,588,593 confirmed cases and 180,064 acknowledged deaths worldwide from COVID-19. This represents an increase of 78,434 (3.1%) cases in the last twenty four hours and an increase of 7,300 (4.2%) overnight deaths around the world. These numbers are worse than yesterday, but the increases seem to have stabilized world-wide even as they shift in geographic locations.

The trends we’ve discussed in recent days still remain. The U.S. continues to lead in total and new cases and deaths. Turkey, the U.K., Brazil, India, Peru and Saudi Arabia are each struggling to contain the spread. Some of these have smaller total numbers, but their infection rates are alarming.

Two countries worth watching are Russia and Singapore. Russia reported extremely small numbers for weeks as the virus spread around the world, even sharing resources with other countries, including the U.S. They now have dramatically improved their testing program and are now reporting one of the highest rates of increases in the world. Perhaps it is simply catching up through the improved testing, but the infection rate is alarming, running at over 10% increases each day.

Singapore should serve as a cautionary tale to the degree that their experience can be compared to other countries. The country felt they had contained the virus and they were held up internationally as a model of dealing with the threat. Then they eased restrictions and the numbers began to rise.

Even with a relatively small population (for a country) of about 5.7 million, their raw numbers are moving them rapidly up the ranks of countries with the highest infections. Their daily increase yesterday registered a rate of 13.9%. To be sure, there are qualities of Singapore’s density and treatment of migrant workers (they are required to live in state-run dormitories which have become hot-beds of infection) that don’t translate elsewhere. But we would be remiss if we didn’t consider their experience as we begin to open up our economies.

Downtown Knoxville During COVID-19 Epidemic, April 2020

National News:

In the numbers, yesterday was another bad one. Yesterday, the U. S. reported 25,985 new cases and 2,804 new deaths. Our current mid-day totals are 820,230 confirmed cases and 45,457 acknowledged deaths. This represents 24 hour increases of 18,071 cases (2.3%) and 1,962 (4.5%) deaths. As bad as the raw numbers appear, this does seem to reflect a continued, gradual slowing in new cases and, perhaps, deaths.

The most significant national developments were the congressional approval of an additional $484 billion for small business loans after previous funds ran out and the president’s declaration that he was halting immigration. As the second of these has sorted out, it has become clear that he is stopping new green card applications for the next sixty days. Temporary workers will continue to be allowed into the country. The explanation for the new move is that Americans should be first in line for new jobs as the economy re-opens.

And re-open, it is. In sweeping moves, particularly across the south, governors, including our own, appear to be racing each other to see who can open up the most and the fastest. Many of these states were among the last two close. It has created still another disconnect between the president, his supporters in the governor’s mansions and the White House medical advisers whose guidelines for reopening have not been met by those states.

Downtown Knoxville During COVID-19 Epidemic, April 2020

State and Local News:

Businesses are beginning to examine what re-opening looks like as the governor has made it clear he will not extend the Stay at Home order beyond May 1. Our county will apparently join the move, according to Dr. Buchanan in yesterday’s press conference. Saying she does not anticipate the coalition of cities, the Knox County and Knoxville City governments recommendations to differ from the governor’s, she said they will all work together. It will be interesting to see if that is the case.

It’s raising dilemmas for many workers. A number of workers, for example, don’t have child care because school is out. Some families are trying to protect elderly or at-risk family members, but that protection diminishes when a family member is greeting the public at work. Also, if a business reopens, workers have little choice but to return to work even if they don’t feel safe because to refuse is also to lose unemployment benefits, a point that has made some suspicious that opening up states is a way to avoid paying unemployment insurance.

The numbers for the state today are 7,394 cases and 157 deaths. This represents a twenty-four hour increase of 156 cases (2.2%) and 5 deaths (3.3%). For Knox County, the latest numbers provided are 199 cases and 4 deaths. This reflects an overnight increase of 3 cases (1.5%) and no deaths. 166 have recovered. In both the state and the county, the numbers continue to increase at about the same, relatively low, pace and are not increasing exponentially.

Knox County Health Department Briefing:

Charity Menefee operated today’s briefing. She said securing supplies has been a struggle here as well as other places. She said they continue to hear reports of people getting tested multiple times and without medical advice (How?!?). She also discouraged people from getting the test to prove immunity. It doesn’t do that. Everyone should continue all the best practices.

She said they want to prioritize people with current symptoms of the virus or have been in close contact with someone who has tested positive, like health care workers. She said people who have had contact should get tested five to ten days after exposure. Almost a thousand people have been tested in the county, with hundreds of those coming in the last few days.

In order to make testing more accessible, they have looked at the map to determine under-tested zip codes and identified 37915 as under-served. As a result, Saturday testing will be at the Knoxville Coliseum from 10 a.m. to 2 p.m. This is drive through or walk up and does not require an appointment. She urged people to consider other options for testing, as well. The health department will continue testing for the next two days.

Questions and Answers:

  • State is providing testing supplies from the state for the Saturday event.
  • Still working on guidelines for reopening the local economy, but they will be released soon.
  • Estimate of baseline amount of testing needed to reopen, there was no clear answer. She said there are a lot of variables.
  • A report is out today that the state is obtaining masks for everyone. True? They have not heard that.
  • Testing supplies are being held back for any specific event like a nursing home outbreak so that they could test the residents.
  • Is the health department considering looking at potential deaths from the virus through autopsies? Yes.
  • Noting the pressure to keep prisoners safe, should they be diagnosed as high risk and should prisoners be released early? She said the Health Department is working with these groups and are satisfied with their current response.
  • Asked about a second wave or seasonality regarding COVID-19, she said a lot is unknown, but those are typical patterns for viruses.
  • Asked about adequate funding for the response, she said the county has stepped forward to support them.
  • Is the health department concerned businesses might follow the governor’s orders vs. local orders, she said they plan to coordinate and they expect support from local businesses.